Provider Demographics
NPI:1720391030
Name:NAYUDU, KIRAN V (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIRAN
Middle Name:V
Last Name:NAYUDU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10007 STEDWICK RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3710
Mailing Address - Country:US
Mailing Address - Phone:240-288-9999
Mailing Address - Fax:
Practice Address - Street 1:10007 STEDWICK RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-3710
Practice Address - Country:US
Practice Address - Phone:240-288-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00257461223G0001X
WI6630-151223G0001X
MD15464122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice